摘要
目的 了解新疆汉族人群乙型肝炎患者乙型肝炎病毒 (HBV)基因型的分布及与临床病情的关系。方法 新疆HBV感染者的血清 2 2 6份 ,包括慢性乙型肝炎轻度、中度、重度、重型肝炎、肝硬化、肝癌患者。采用型特异性引物巢式PCR方法对血清中的HBV进行基因分型。结果 新疆汉族人群HBV基因型以B、C混合型为主 ,占 43 .8% (99/2 2 6) ,B型 3 1.46% (71/2 2 6) ,C型 2 4.3 4% (5 5 /2 2 6) ,未分型 1例 (0 .44 % ) ,未见有A、D、E、F型分布。随机选取的 4株HBV株经S基因序列的测定证实与本检测结果一致。C型HBV感染者的平均ALT、AST、γ GT、AKP水平及HBVDNA浓度均高于B型、B +C型者 (P >0 .0 5 ) ,C、B +C型TBIL平均水平高于B型 ,差异有统计学意义 (P <0 .0 5 )。C型HBV感染者TP平均水平低于B、B +C型患者 (P >0 .0 5 )。随着病情的加重 ,C型所占百分比逐渐高于B、B +C型 ,在LC、HCC中分别为3 6.4% ,2 7.3 % ,C型感染者抗HBe阳性率逐渐增高 ,在HCC中B、C、B +C混合型者中抗HBe阳性率分别为 2 6.7%、42 .9%和 3 2 .6% (P >0 .0 5 )。结论 新疆汉族人群HBV患者存在B、C与B +C基因型 ,以B、C混合型为主 ,基因型的分布与国内其它地方汉族人群相比有自身特点 ,且与临床病情有关 ,除TBIL外 ,各型在临床生化指标方面?
Objective To investigate the distribution characteristics of hepatitis B virus(HBV)genotypes and relationship between the genotypes of HBV and clinical courses in groups of the Han nationality in XiuJiang.Methods Serum samples of 226patients from the groups of the Han nationality in XinJang of China,infected chronically with mild,moderate,severe,fulminant hepatitis,liver cirrhosis (LC) and hepatocellular carcinoma (HCC),were genotyped by PCR with genotype specific primers.The S nucleotide sequences of HBV strains isolated from serum samples of 4 patients selected randomly were detected to confirm the result.Result GenotypeB?C and nonA?D?E?F were found in this group,in which 43.8%(99/226)were genotype B+C,31.4%(71/226)genotype B,24.36%(55/226)genotype C,only 1 case (0.44%)unspecified.Genotype B+C is predominant it this region.The results of sequencing were identical with that genotyped by the PCR method.Different clinical courses have statistical difference in distribuiton between genotype B and C,between C and B+C(xa2=14.659,P<a0.01,xa2=12.698,P<a0.01,respectively).The average levels of alanine aminotransferase (ALT)?aspartate aminotransferase(AST)?γglutamyltranspeptidase(γ-GT)?alkaline phosphatase(AKP)and HBV DNA of genotype C were higher than those of genotype B and B+C(P>a0.05).The average levels of total bilirubin (TBIL)of gentvpe C and B+C were higher than that of genotype B (P￡0.05).The average level of total protein of genotype C was lower than those of genotype B and B+C(P>0.05).With the aggravations of patients'condition,percentages of genotype C were gradually higher than genotype B,especially in LC and HCC (36.4% and 27.3%,respectively)and the rate of hepatitis B e antibody of genotype C was improved,these rates of genotype B?C?B+C in HCC were 26.7%, 42.9 % and 37.6%,respectively.Conclusion Genotypes B?C and B+C exist in groups of the Han nationality in XinJiang.The major one is genotype B+C.The distribution is different from the Han nationality patients of the other areas.It might be related with this particular multi-nationality area.Genotypes of HBV correlates with clinical courses.Genotype C is probably associated with the severity of liver disease,but relationship between the genotype B+C and clinical courses of HBV infection need do more and further study.
出处
《实用肝脏病杂志》
CAS
2005年第1期11-15,共5页
Journal of Practical Hepatology
